Surgical access device and method for using the same

ABSTRACT

A smoke evacuator for use with a surgical access device includes an evacuation ring having an inner peripheral surface defining one or more channels therein disposed in fluid communication with an operating cavity. A connection port is disposed thereon in fluid communication with the channel(s) and adapted to connect to a smoke evacuation system. The evacuation ring includes a profile having an inner flange that forms part of the inner peripheral surface of the evacuation ring and one or more lower flanges, the inner flange is configured to mechanically engage a rim of an access device and the lower flange(s) is adapted to mechanically engage a wound guard, wherein engagement of the inner flange of the evacuation ring atop the access device and engagement of the lower flange(s) with the wound guard secures the access device, the wound guard and the smoke evacuation ring within the operating cavity.

FIELD

The present disclosure relates to tissue specimen removal and, moreparticularly, to surgical access devices and systems incorporating thesame for use in tissue specimen removal procedures and other surgicalprocedures.

BACKGROUND

In minimally-invasive surgical procedures, operations are carried outwithin an internal body cavity through small entrance openings in thebody. The entrance openings may be natural passageways of the body ormay be surgically created, for example, by making a small incision intowhich a cannula is inserted.

Minimally-invasive surgical procedures may be used for partial or totalremoval of tissue from an internal body cavity. However, the restrictedaccess provided by minimally-invasive openings (natural passagewaysand/or surgically created openings) presents challenges with respect tomaneuverability and visualization. The restricted access also presentschallenges when large tissue specimens are required to be removed. Assuch, tissue specimens that are deemed too large for intact removal maybe broken down into a plurality of smaller pieces to facilitate removalfrom the internal body cavity. Typically, a surgical sleeve and aspecimen containment bag are used for this purpose. Moreover, duringspecimen rescission, smoke may cloud the operating site and may requireevacuation therefrom. Smoke evacuation systems are commonplace for usewith the surgical sleeve.

SUMMARY

As used herein, the term “distal” refers to the portion that isdescribed which is further from a user, while the term “proximal” refersto the portion that is being described which is closer to a user.Further, any or all of the aspects described herein, to the extentconsistent, may be used in conjunction with any or all of the otheraspects described herein.

Provided in accordance with aspects of the present disclosure is a smokeevacuator for use with a surgical access device which includes anevacuation ring having an inner peripheral surface defining one or morechannels therein disposed in fluid communication with an operatingcavity. A connection port is disposed thereon in fluid communicationwith the channel(s) and is adapted to connect to a smoke evacuationsystem. The evacuation ring includes a profile having an inner flangethat forms part of the inner peripheral surface of the evacuation ringand one or more lower flanges. The inner flange is configured tomechanically engage a rim of an access device and the lower flange(s) isadapted to mechanically engage a wound guard, wherein engagement of theinner flange of the evacuation ring atop the access device andengagement of the lower flange(s) with the wound guard secures theaccess device, the wound guard and the smoke evacuation ring within theoperating cavity.

In aspects according to the present disclosure, the profile of theevacuation ring is U-shaped and includes an inner flange that forms partof the inner peripheral surface of the evacuation ring, an upper flangeand one or more lower flanges, the upper flange is configured tomechanically engage the rim of the access device and the lower flange(s)is adapted to mechanically engage a corresponding number of aperturesdefined within the wound guard.

In aspects according to the present disclosure, the evacuation ring isresilient to facilitate mechanical engagement atop the access device andwith the wound guard. In other aspects according to the presentdisclosure, the evacuation ring includes an outer peripheral surfaceconfigured to complement an adjoining surface of the access device. Instill other aspects according to the present disclosure, the profile ofthe evacuation ring includes a series of lower flanges configured toengage a corresponding series of apertures defined in the wound guard.In yet other aspects according to the present disclosure, the series oflower flanges are arranged in opposing pairs about the evacuation ring.

Provided in accordance with another aspect of the present disclosure isa smoke evacuator for use with a surgical access device which includesan evacuation ring having: an inner peripheral surface having one ormore channels defined therein disposed in fluid communication with anoperating cavity; a connection port disposed thereon in fluidcommunication with the channel(s) and adapted to connect to a smokeevacuation system; an elongated sleeve having a ring-like distal end,the ring-like distal end configured to operably engage a distal end of awound guard to bias the distal end outwardly to engage tissue; and alocking flange disposed at a proximal end thereof adapted to operablyengage a proximal ring of an access device, wherein engagement of thelocking flange of the evacuation ring with the access device andengagement of the distal end of the elongated sleeve of the evacuationring with the distal end of the wound guard secures the access device,the wound guard and the smoke evacuation ring within the operatingcavity.

In aspects according to the present disclosure, the distal end of theelongated sleeve of the evacuation ring operably engages a pair ofbifurcated ends of the wound guard to bias the ends outwardly to engagetissue. In other aspects according to the present disclosure, thelocking flange includes one or more locking ends configured to operablyengage an underside of the proximal ring of the access device. In yetother aspects according to the present disclosure, the locking flangeincludes one or more releases configured to uncouple the locking endfrom the underside of the proximal ring of the access device.

Provided in accordance with another aspect of the present disclosure isa surgical system for accessing a surgical cavity which includes: anaccess device configured for insertion within an operating cavity; awound guard configured for insertion within the access device; and asmoke evacuator configured to secure the access device and wound guardwithin the operating cavity. The smoke evacuator includes an evacuationring having: an inner peripheral surface having one or more channelsdefined therein disposed in fluid communication with the operatingcavity; a connection port disposed thereon in fluid communication withthe channel(s) and adapted to connect to a smoke evacuation system; anelongated sleeve having a ring-like distal end, the ring-like distal endconfigured to operably engage a distal end of the wound guard to biasthe distal end outwardly to engage tissue; and a locking flange disposedat a proximal end thereof adapted to operably engage a proximal ring ofthe access device, wherein engagement of the locking flange of theevacuation ring with the access device and engagement of the distal endof the elongated sleeve of the evacuation ring with the distal end ofthe wound guard secures the access device, the wound guard and the smokeevacuation ring within the operating cavity.

In aspects according to the present disclosure, the distal end of thewound guard is bifurcated and the distal end of the elongated sleeve ofthe evacuation ring operably engages the bifurcated ends of the woundguard to bias the ends outwardly to engage tissue.

In aspects according to the present disclosure, the locking flangeincludes one or more locking ends configured to operably engage anunderside of the proximal ring of the access device. In other aspectsaccording to the present disclosure, the locking flange includes at oneor more releases configured to uncouple the locking end from theunderside of the proximal ring of the access device.

In aspects according to the present disclosure, the wound guard includesone or more holes defined therein configured to facilitate removal ofthe wound guard from the access device. In other aspects according tothe present disclosure, the bifurcated distal ends of the wound guardare resilient and inwardly biased to facilitate insertion within theaccess device

Provided in accordance with another aspect of the present disclosure isa surgical system for accessing a vaginal cavity which includes anaccess device configured for insertion within an operating cavity, theaccess device including an elongated sleeve having a proximal ringdisposed at a proximal end thereof and an anchoring ring disposed at adistal end thereof. The anchoring ring is inwardly biased to facilitateinsertion within a vaginal canal and the proximal ring is configured toseat against tissue outside the vaginal canal. A wound guard isconfigured for insertion within the access device. The wound guardincludes an elongated sleeve having a proximal ring disposed at aproximal end thereof and biasing ring at a distal end thereof. Thebiasing ring, upon insertion, is configured to bias the anchoring ringoutwardly to engage tissue within the vaginal canal to secure both theaccess device and wound guard therein.

In aspects according to the present disclosure, the cross sectionalprofile of the anchoring ring is bulbous to facilitate engagement withtissue within the vaginal canal. In other aspects according to thepresent disclosure, the proximal ring of the wound guard is configuredto seat atop the proximal ring of the access device. In yet otheraspects according to the present disclosure, the anchoring ring of theaccess device is split to include a series of anchoring portionsconfigured in a ring-like manner.

Provided in accordance with another aspect of the present disclosure isa method for sizing a wound guard in a surgical system for accessing asurgical cavity, which includes: inserting an access device within asurgical or natural opening; tenting the access device to secure theaccess device within the opening; repeatedly inserting one of a serieswound guards of varying length within the access port until the woundguard is properly sized therein; and engaging a smoke evacuator atop theaccess device to secure the wound guard to the access device within thesurgical cavity.

In aspects according to the present disclosure, the length of the seriesof wound guards range from about 2 cm to about 8 cm. In other aspectsaccording to the present disclosure, the smoke evacuator operablyengages the wound guard to secure the wound guard to the access device.In yet other aspects according to the present disclosure, the methodfurther includes: attaching a connection port operably associated withthe smoke evacuator to a smoke evacuation system; and activating thesmoke evacuation system to remove smoke from the operating cavity duringsurgery

Provided in accordance with another aspect of the present disclosure isa surgical system for accessing an operating cavity, which includes anaccess device configured for insertion within an operating cavity, theaccess device including an elongated sleeve having proximal and distalrims disposed on opposing sides thereof. The distal rim is configuredfor insertion within an operating cavity and the proximal rim isconfigured to seat against tissue outside the operating cavity. A woundguard is configured for insertion within the access device. The woundguard includes a pair of interleaved arcuate portions each having astrap slot defined therein configured to receive a respective strap.Each strap includes a proximal end configured to operably engage theproximal rim of the access device and a distal end configured to engagethe distal rim of the access device. In use, tension on the pair ofstraps during insertion and adjustment of the access device moves thepair of interleaved arcuate portions relative to one another tofacilitate properly sizing the wound guard within the access device.

In aspects according to the present disclosure, the pair of interleavedarcuate portions includes a first arcuate portion having a solid distalend and a second arcuate portion having a split distal end defining anelongated slot therein configured to receive the solid distal end. Inother aspects according to the present disclosure, adjusting theproximal rim of the access device to secure the access device within theoperating cavity automatically adjusts the arcuate portions to size thewound guard therein.

BRIEF DESCRIPTION OF THE DRAWINGS

The above and other aspects and features of the present disclosure willbecome more apparent in light of the following detailed description whentaken in conjunction with the accompanying drawings wherein likereference numerals identify similar or identical elements.

FIG. 1A is an exploded, top, perspective view of a system provided inaccordance with the present disclosure including an access device and atissue guard;

FIG. 1B is a cross-sectional view of the system of FIG. 1A disposedwithin an opening in tissue;

FIG. 2A is a front cross sectional view of the access device with thetissue guard inserted therein;

FIG. 2B is an enlarged view of the area of detail of FIG. 2A;

FIG. 2C is a greatly-enlarged view showing the engagement of a proximalflange of the tissue guard within a proximal rim the access device;

FIG. 3A is a top perspective view of another embodiment of a tissueguard for use with the access device;

FIG. 3B is a top perspective view of the tissue guard of FIG. 3A engagedto a proximal rim of the access device;

FIGS. 4A-4B is a system provided in accordance with the presentdisclosure including an access device, a series of tissue guards ofvarying lengths and a smoke evacuation ring;

FIGS. 5-6D are various views of a smoke evacuation ring for use with oneor more of the access devices and tissue guards of FIGS. 1A-4B;

FIGS. 7A-7B are side, cross-sectional views of another embodiment of asmoke evacuation ring for use with one or more of the access devices andtissue guards of FIGS. 1A-6D;

FIGS. 8A-8B are side, cross-sectional views of another embodiment of asmoke evacuation ring for use with one or more of the access devices andtissue guards of FIGS. 1A-6D;

FIGS. 9A-9B are side, cross-sectional views of an access device and atissue guard for use with vaginal surgeries;

FIGS. 10A-10B are various views of an adjustable tissue or wound guardfor use with one or more of the access devices of FIGS. 1A-6D;

FIG. 11 is a top perspective view of the wound guard of FIGS. 10A and10B shown attached to an access device; and

FIG. 12 is a schematic illustration of a smoke evacuation system for usewith one or more of the access devices and wound guards of FIGS. 1A-11.

DETAILED DESCRIPTION

Turning to FIGS. 1A and 1B, an exemplary system 100 provided inaccordance with the present disclosure includes a tissue guard 110 andan access device 150. Tissue guard 110 is monolithically formed as asingle piece of material, e.g., a biocompatible plastic such as, forexample, polyethylene, polycarbonate, etc., from any suitable method,e.g., injection molding. The material, thickness, and configuration oftissue guard 110 are such that tissue guard 110 defines sufficientstiffness to maintain its shape when positioned within an opening intissue “T” and/or when engaged within access device 150. However, thematerial, thickness, and configuration of tissue guard 110 also providesufficient resilient flexibility to permit manipulation of tissue guard110 from an at-rest position for insertion into an opening in tissue “T”and/or for engagement within access device 150, with tissue guard 110returning to or towards the at-rest position after insertion and/orengagement as explained in more detail below. Further, the material,thickness, and configuration of tissue guard 110 is selected such thattissue guard 110 is configured to withstand cutting and puncturing bysurgical knives, scalpels, pencils, and the like, thereby protectingsurrounding tissue “T” and/or access device 150 from being cut orpunctured. Tissue guard 110 may additionally or alternatively beconfigured to inhibit transfer of thermal and/or electrical energytherethrough to protect surrounding tissue “T” and/or access device 150from thermal and/or electrical energy.

Continuing with reference to FIGS. 1A and 1B, tissue guard 110 includesa body 112 defining an open proximal end 114, an open distal end 116,and a lumen 118 extending therethrough between open proximal and distalends 114, 116, respectively. Lumen 118 defines a longitudinal axis 120and is configured to receive one or more surgical instruments (notshown) therethrough. In embodiments, body 112 defines a funnel-shapedconfiguration wherein a diameter of body 112 at open proximal end 114thereof is greater than a diameter of body 112 at open distal end 116thereof. Additionally or alternatively, the exterior surface 122 of body112 may define a generally concave configuration while the interiorsurface 124 of body 112, which defines lumen 118, may define a generallyconvex configuration.

Access device 150 may be configured as a tissue retractor, an accessport, or other suitable access device configured for positioning withinan opening in tissue “T,” e.g., a surgical incision or anaturally-occurring orifice, to provide access therethrough into aninternal surgical site. Access device 150 includes a proximal rim 152configured for positioning on an external side of the opening in tissue“T,” a distal rim 154 configured for positioning on an internal side ofthe opening in tissue “T,” and a body 156 extending between proximal anddistal rims 152, 154, respectively. Body 156 is configured to extendthrough the opening in tissue “T” and defines a passageway 158 extendinglongitudinally therethrough to permit access to an internal surgicalsite through the opening in tissue “T.” Passageway 158 defines alongitudinal axis 160. At least a portion of body 156 of access device150 may be flexible to facilitate insertion and positioning of accessdevice 150 within the opening in tissue “T.” In embodiments, body 156 isformed from a flexible sleeve of material including one or more layersof material. Further, access device 150 may be selectively adjustable,e.g., by rolling proximal rim 154 distally about body 156, to retracttissue “T” and/or secure access device 150 within the opening in tissue“T.” Access device 150 may further define an inwardly-extending overhang162 between proximal rim 154 and body 156 and extending annularly aboutpassageway 158.

As shown in FIG. 1B, in use, access device 150 is positioned within anopening in tissue “T” such that, as noted above, distal rim 154 isdisposed on an internal surface of tissue “T” on the internal side ofthe opening in tissue “T,” body 156 extends through the opening intissue “T,” and proximal rim 152 is disposed on an exterior surface oftissue “T” on the external side of the opening in tissue “T.” As alsonoted above, access device 150 may be adjusted to conform access device150 to a patient's anatomy, retracting tissue “T” and/or securing accessdevice 150 within the opening in tissue “T.” With access device 150disposed within the opening in tissue “T,” tissue guard 110, led by opendistal end 116 thereof, is inserted into passageway 158.

Turning now to FIGS. 2A-2B, tissue guard 110 includes a lip 126extending radially outwardly from open proximal end 114 of body 112about the annular perimeter thereof. In this manner, lip 126 extendsradially outwardly from lumen 118. Lip 126 may extend radially outwardlyfrom body 112 at an oblique angle relative thereto. Lip 126 alsoincludes an annular finger 129 extending from an outer peripheralsurface thereof that is configured to anchor the tissue guard 110 withinthe access device 150. More particularly, annular finger 129 includes aflange 129 a disposed at a distal end thereof that is configured toengage an underside of rim 152 of access device 150 to secure the tissueguard 110 therein. Finger 129 is configured to flex between an insertionposition wherein the finger 129 is disposed in an abutting relationshipwith body 112 and a locking position wherein finger 129 flexes under abias to engage flange 129 a under rim 152 (FIG. 2B).

Flange 129 a is angled to both facilitate insertion and to facilitateengagement. More particularly, an outer peripheral surface 127 a offlange 129 a is disposed at a first angle alpha (α) in the range fromabout 45 degrees to about 60 degrees to encourage the finger 129 and,hence, the tissue guard 110, to slip into lumen 118 and an innerperipheral surface 127 b is disposed at second angle beta (β) in therange from about 60 degrees to about 80 degrees to facilitate engagementof flange 129 a with the underside of rim 152 (FIGS. 2B and 2C).

In embodiments, finger 129 may be configured to “snap” into engagementwith the underside of rim 152 and, in such embodiments, may produce anaudible and/or tactile response that confirms the engagement of tissueguard 110 within access device 150.

With tissue guard 110 engaged within access device 150 as detailedabove, surgical instrumentation may be inserted through lumen 118 oftissue guard 110 into the internal surgical site to, for example,extract a tissue specimen therefrom. Tissue guard 110, as noted above,protects tissue “T” as well as access device 150 during the insertion,manipulation, use and withdrawal of any such surgical instrumentation.

Turning to FIGS. 3A-3B, another tissue guard 510 provided in accordancewith the present disclosure is shown. With additional momentaryreference to FIG. 2A, tissue guard 510 is similar to tissue guard 110except as explicitly contradicted below and may be used in conjunctionwith access device 150 as part of a system similar to system 100. Forpurposes of brevity, only differences between tissue guard 510 andtissue guard 110 are detailed below, while similarities are summarilydescribed or omitted.

Tissue guard 510 includes a body 512 defining an open proximal end 514,an open distal end 516, and a lumen 518 extending therebetween. A lip526 extends radially outwardly from open proximal end 514 of body 512and includes a plurality of fingers 529 extending from an outerperipheral surface thereof. The fingers 529 may be equidistantly-spacedabout the lip 526 or may be spaced an any particular manner dependingupon a particular purpose. In embodiments, a continuous finger (notshown) may be annularly spaced about the lip 526.

Each finger 529 includes an arcuate channel 531 defined along an innerperipheral surface thereof configured to at least partially encapsulateor mount atop rim 152 of the access device 150. More particularly, whenthe tissue guard 510 is first inserted into access device 150, channel531 of each finger 529 aligns atop rim 152 of access device 150 and ispoised for engagement atop rim 152 when the fingers 529 are secured.Each finger 529 also includes a flange 529 a disposed at a distal endthereof that is configured to engage an underside of rim 152 to securethe tissue guard 510 in place. Finger 129 is configured to flex uponinsertion of the tissue guard 510 into access device 150 by virtue ofrim 152 forcing flange 529 a and finger 529 outwardly as the tissueguard 510 is inserted. Upon full insertion of the tissue guard 510 intoaccess device 150, the channel 531 of finger 529 encapsulates the rim152 while the flange 529 a snaps into place under rim 152 therebylocking the tissue guard 510 atop access device 150. The finger 529 isbiased in the locked position. The flange 529 a extends inwardlyrelative to the proximal ring 152 and operably engages the underside ofthe proximal ring 152 when biased.

Flange 529 a may be angled to both facilitate insertion and tofacilitate engagement. More particularly, an outer peripheral surface527 a of flange 529 a may be disposed at a first angle lambda (λ) in therange from about 60 degrees to about 80 degrees to encourage the finger529 and, hence, the tissue guard 510, to slip into lumen 118 and aninner peripheral surface 527 b is disposed at second angle phi (φ) inthe range from about 45 degrees to about 60 degrees to facilitateengagement of flange 529 a with the underside of rim 152 (FIG. 3B). Theshape of channel 531 may be dimensioned to conform to the shape of theouter peripheral surface of rim 152. Moreover, the height of the channel531 may be dimensioned slightly larger than the thickness and depth ofthe rim 152 to facilitate engagement.

The distal end 516 of tissue guard 510 includes a plurality ofscallop-like tabs 516 a spaced-apart annularly thereabout. Scallop-liketabs 516 a are configured engage an inner peripheral surface of body 112of the access device 150 and are contoured or scalloped to generallymimic the shape thereof. The scallop-like tabs 516 a are biasedoutwardly to maximize the opening at the distal end 516 of the tissueguard 510 and effectively secure the distal end 516 of the tissue guard510 within access device 150 thereby facilitating surgical instrumentaccess to the body cavity.

As mentioned above, lips 126, 526 define an annular channel thereinconfigured to direct surgical exhaust therethrough to their respectiveports 165, 565 defined in an outer peripheral surface of lips 126, 526.Lips 126, 526 include distal ends 126 a, 526 a that each extend inwardlytherefrom towards lumens 118, 518 to form annular channels 145, 545configured to direct surgical exhaust gas to ports 165, 565,respectively. One or more slits or passageways 113 (FIG. 12) may bedefined within the inner peripheral surface of distal ends 126 a, 526 athat allow surgical gases passage into annular channels 145, 545,respectively. As explained in more detail below, each port 165, 565 isconfigured to connect to an exhaust connection 776 of a fluid managementor smoke evacuation system 700 (FIG. 12). In other words, lips 126, 526are each configured as generally hollow sleeves disposed proximate theinner peripheral surface of respective proximal ends 114, 514 of tissueguards 110, 510 and are configured to direct evacuation fluids and smoketo the exhaust connection 776 and to the fluid management or smokeevacuation system 700.

Turning to FIGS. 4A-4B, one embodiment of a smoke evacuation member isshown and is generally designated as reference numeral 620. Smokeevacuation member 620 includes an evacuation ring 626 that defines anannular channel 626′ therein configured to convey smoke, odors andmiscellaneous gases from the operating cavity to a smoke evacuationsystem 700 (FIG. 12). More particularly, evacuation ring 626 isgenerally annular in shape and includes a connection port 627 thatoperably couples to tubing 710 of the smoke evacuation system 700.Evacuation ring 626 is configured to operably couple to the proximal rim152 of access device 150 (FIG. 4B) via one or more mechanicallyinterfacing surfaces. More particularly, evacuation ring 626 isgenerally U-shaped and includes an inner peripheral edge 626 a and anouter peripheral edge 626 c connected via upper flange 626 b. Upperflange 626 b includes connection port 627 disposed thereon. A lowerflange 626 d extends inwardly towards the operating cavity at varyinglocations along the edge 626 c (See FIG. 4B) and is configured tooperably engage an underside of rim 152 to secure the evacuation ring626 atop the access device 150 (See FIG. 4B).

Evacuation ring 626 is also configured to engage a wound guard, e.g.,wound guard 612 a, to secure the wound guard 612 a within the accessdevice 150. More particularly, inner peripheral edge 626 a of theevacuation ring 626 may be configured to mechanically secure the woundguard 612 a within access device 150 upon engagement with rim 152thereof. Wound guards 612 a-612 c of varying length may be inserted andsized within access device 150 and, once the properly-sized wound guard,e.g., wound guard 612 a, is in place, thereafter secured therein viacoupling of the evacuation ring 626 thereon. Wound guards 612 a-612 cmay vary in length from about 2 cm to about 8 cm.

In use, once the access device 150 is positioned within the operatingcavity, the surgeon can insert one or more wound guards 612 a-612 ctherein to size the wound guard, e.g., 612 a, within the cavity. Whenthe desired wound guard 612 a is in place, the evacuation ring 626 isthen secured to the proximal rim 152 thereby securing the wound guard612 a in place within the cavity.

During use, the wound guard 612 a may be easily exchanged for a longeror shorter wound guard, e.g. 612 c, and the evacuation ring 626remounted atop the rim 152 to secure the same. As the tissue specimen isbeing excised, smoke emanating from the operating site is removed viathe smoke evacuation system 700. More particularly, smoke is suckedunder negative pressure from the operating cavity and through anaperture 629 defined in the inner peripheral edge 626 a of ring 626 andto connection port 627. From the connection port 627, the smoke istransported via tubing 710 to the smoke evacuation system 700 (FIG. 12).

FIGS. 5-6D show additional embodiments of evacuation rings 726 and 826for use with any of the systems and wound guards described herein.Evacuation ring 726 includes a generally circular shape having an innerperipheral surface 726′ defining a series of channels 729 thereinconfigured to communicate with the operating cavity (FIG. 5). Evacuationring 726 is configured to snap atop the access device 150 and operablycouple to the wound guard 712 to secure both the wound guard 712 and theaccess device 150 in place while at the same time allowing smoke to besafely and effectively evacuated through channels 729 to connection port727 and, ultimately, to smoke evacuation system 700. The cross sectionalprofile of evacuation ring 726 is generally J-shaped to facilitatesecure engagement both atop access device 150 and to wound guard 712.One or more mechanical interfaces (not shown) may be utilized to furthersecure the evacuation ring 726 to the access device 150 and/or woundguard 712, e.g., tabs, ridges, flanges, etc.

FIGS. 6A-6D show evacuation ring 826 for use with any of the systems andwound guards described herein. Evacuation ring 826 includes a generallycircular shape having an inner peripheral surface 826 a defining aseries of channels 829 therein configured to communicate with theoperating cavity. Evacuation ring 826 is configured to snap atop theaccess device 150 and operably couple to the wound guard 812 to secureboth the wound guard 812 and the access device 150 in place while at thesame time allowing smoke to be safely and effectively evacuated throughchannels 829 to connection port 827 and, ultimately, to smoke evacuationsystem 700.

The cross sectional profile of evacuation ring 826 is generally U-shapedto facilitate secure engagement both atop access device 150 and to woundguard 812. More particularly, the U-shaped cross section includes innerperipheral surface 826 a having an upper flange 826 c and a series oflower flanges 826 b. Upper flange 826 c is configured to operably coupleatop (or otherwise mechanically engage) access device 150 and each ofthe series of lower flanges 826 b is configured to operably couple (orotherwise mechanically engage) to wound guard 812. The lower flanges 826b may be arranged in opposing pairs about the evacuation ring 826. Theevacuation ring 826 includes an outer peripheral surface 835 configuredto complement an adjoining surface of the access device 150.

Wound guard 812 may include one or more apertures 812 b defined theinconfigured to mechanically couple to a corresponding number of lowerflanges 826 b. An upper end of wound guard 812 may be resilient tofacilitate engagement of the corresponding mechanical components. One ormore mechanical interfaces (not shown) may be utilized to further securethe evacuation ring 826 to the access device 150, e.g., tabs, ridges,flanges, etc.

In use, the user inserts access device 150 into an operating cavity,inserts a wound guard 812 therein and then mounts the evacuation ring826 atop rim 152 of the access device 150 while at the same timemechanically engaging flanges 826 b within apertures 812 b. This securesall of the components for use. The user simply reverse the process touncouple the evacuation ring 826 from the wound guard 812 and accessdevice 150.

FIGS. 7A-7B show another embodiment of an evacuation ring 926 for usewith any of the systems and wound guards described herein. Evacuationring 926 includes a generally circular shape having an inner peripheralsurface 926′ defining a series of channels 929 therein configured tocommunicate with the operating cavity. Evacuation ring 926 also includesan elongated sleeve 929 that has a ring-like distal end 931. Evacuationring 926 is configured to snap atop the access device 150 and operablycouple inside the wound guard 912 to secure both the wound guard 912 andthe access device 150 in place while at the same time allowing smoke tobe safely and effectively evacuated through channels 929 to connectionport 927 and, ultimately, to smoke evacuation system 700.

FIG. 7A shows the access device 150 and wound guard 912 prior toengagement with the evacuation ring 926. Wound guard 912 is bifurcatedat a distal end thereof forming ends 913 a and 913 b. Prior to insertionof the evacuation ring 926, the natural bias of the material of thewound guard 912 maintains the ends 913 a, 913 b approximated therebyfacilitating insertion into the operating cavity. Upon insertion of theevacuation ring 926, the ring-like distal end 931 of evacuation ring 926forces the bifurcated distal ends 913 a, 913 b outwardly against thetissue of the operating cavity thereby locking the assembled components(e.g., access device 150, wound guard 912 and evacuation ring 926) inplace for use. A locking flange 930 locks atop the access device 150after insertion to secure the evacuation ring 926 about the rim 152 ofthe access device (FIG. 7B).

FIGS. 8A-8B show anther embodiment of an evacuation ring 1026 for usewith any of the systems and wound guards described herein. Evacuationring 1026 includes a generally circular shape having an inner peripheralsurface 1026′ defining a series of channels 1029 therein configured tocommunicate with the operating cavity. Evacuation ring 1026 alsoincludes an elongated sleeve 1029 that includes a ring-like distal end1031. Evacuation ring 1026 is configured to snap atop the access device150 and operably couple inside the wound guard 1012 to secure both thewound guard 1012 and the access device 150 in place while at the sametime allowing smoke to be safely and effectively evacuated throughchannels 1029 to connection port 1027 and, ultimately, to smokeevacuation system 700.

FIG. 8A shows the access device 150 and wound guard 1012 prior toengagement with the evacuation ring 1026. Wound guard 1012 is bifurcatedat a distal end thereof forming ends 1013 a and 1013 b. Prior toinsertion of the evacuation ring 1026, the natural bias of the materialof the wound guard 1012 maintains the ends 1013 a, 1013 b approximatedthereby facilitating insertion into the operating cavity. Upon insertionof the evacuation ring 1026, the ring-like distal end 1031 of evacuationring 1026 forces the bifurcated distal ends 1013 a, 1013 b outwardlyagainst the tissue of the operating cavity thereby locking the assembledcomponents (e.g., access device 150, wound guard 1012 and evacuationring 1026) in place for use. A locking flange 1030 locks atop the accessdevice 150 after insertion to secure the evacuation ring 1026 about therim 152 of the access device 150.

Locking flange 1030 is split at a distal end thereof forming locking end1031 a and release 1031 b. Locking end 1031 a is configured to curlunder rim 152 to further secure the evacuation ring 1026 to the accessdevice 150. Release 1031 b projects opposite end 1031 a and isconfigured to facilitate uncoupling the evacuation ring 1026 from theaccess device 150 when pulled. Wound guard 1012 includes one or moreholes 1019 defined therein near a proximal end thereof that areconfigured to facilitate removal of the wound guard 1012 from the accessdevice 150.

FIGS. 9A and 9B show an alternate embodiment of a wound guard 2100 foruse with an access device 2000 for various types of vaginal surgeries,e.g. hysterectomies. Wound guard 2100 operates in a similar fashion toevacuation rings 926, 1026 discussed above with respect to FIGS. 7A-8B.More particularly, access ring 2000 is placed inside the vaginal canal“VC” of a woman's vagina and the wound guard 2100 is inserted therein tosecure the access device 2000 and wound guard 2100 in place forintroduction of surgical instrumentation or surgical extraction oftissue.

Access device 2000 includes an elongated generally tubular sleeve 2010(shown in cross section as sleeve sides 2010 a, 2010 b) having anannular rim 2014 disposed at a proximal end thereof and an anchorportion 2016 disposed at a distal end thereof. Annular rim 2014 is shownin cross section as rims 2014 a and 2014 b and anchor portion 2016 isshown in cross section as anchors 2016 a and 2016 b. Anchors 2016 a,2016 b are made from a material that, prior to insertion, is naturallyinwardly biased to reduce the annular diameter of the distal end of theaccess device 2000 to facilitate insertion.

Wound guard 2100 includes an elongated generally tubular sleeve 2110(shown in cross section as sleeve sides 2110 a, 2110 b) having anannular rim 2114 disposed at a proximal end thereof and a biasing oranchoring ring 2116 disposed at a distal end thereof. Annular rim 2114is shown in cross section as rims 2114 a and 2114 b and biasing portion2016 is shown in cross section as biasing ends 2116 a and 2016 b.Likewise, in the cross sectional view, anchoring ring 2016 includesbiasing ends 2016 a, 2016 b made from a material that, during insertion,is naturally outwardly biased to expand the annular diameter of thedistal end of the access device 2000 to facilitate engagement of theaccess device 2000 to the vaginal walls.

In use, the access device 2000 is inserted into the vaginal canal “VC”with the annual rim 2014 remaining outside the vaginal opening. Thebiasing portion 2116 of the wound guard 2100 is squeezed to reduce theannular profile (e.g., distance between biasing ends 2116 a, 2116 b) tofacilitate insertion of the wound guard 2100 into the access device2000. Once inserted, the biasing portion is released forcing the anchorportion 2016 against the vaginal wall (i.e., the anchors 2016 a, 2016 bare wedged into the vaginal wall) thereby securing the access device2000 and wound guard 2100 in place for use. After surgery, the woundguard 2100 is removed allowing the access device 2000 and anchors 2016a, 2016 b to return to their natural inwardly-biased configurationfacilitating removal from the vaginal canal “VC”.

The cross sectional profile of the anchoring ring 2016 (or ends 2016 a,2016 b) may be bulbous to facilitate engagement with tissue within thevaginal canal. Moreover, the proximal ring 2114 of the wound guard 2100is configured to seat atop the proximal ring 2014 of the access device2000. The anchoring ring 2016 of the access device 2000 may be split toinclude a series of anchoring portions or ends, e.g., 2016 a, 2016 bconfigured in a ring-like manner.

FIGS. 10A-11 show an alternate embodiment of a wound guard 3100 for usewith an access device 3000 for various types of surgeries. Access device3000 includes upper and lower rims 3152, 3154, respectively, joined byan elongated sleeve 3005. Wound guard 3100 operates in a similar fashionand is made from similar materials as those described above and, assuch, only the differences are described in detail. More particularly,wound guard 3100 includes a generally circular shape including twoarcuate portions 3110 and 3120 that are configured to interleave withone another to allow a user to alter the diameter “D” of the wound guard3100 for a particular purpose. Arcuate section 3110 includes a soliddistal end 3110 a and arcuate section 3120 includes two distal endportions 3120 a, 3120 b that define an elongated slot 3123 therebetweenconfigured to receive distal end 3110 a.

Both arcuate portion 3110 and 3120 also include strap slots 3130 a and3130 b defined therein and configured to receive a respective strap 3140a, 3140 b therethrough. More particularly, strap slot 3130 a isconfigured to receive strap 3140 a therethrough while strap 3140 a issecured at end 3141 a to upper rim 3152 and at end 3142 a to lower rim3154 of access device 3000. Strap slot 3130 b is configured to receivestrap 3140 b therethrough while strap 3140 b is secured at end 3141 b toupper rim 3152 and at end 3142 b to lower rim 3154 of access device3000.

In use, the user inserts rim 3154 into an incision or vaginal canalallowing rim 3154 to expand and engage against the internal tissue ofthe wound or canal. As described above, rim 3152 is then rolled towardthe incision (or canal) to expand the incision and further secure theaccess device 3000 in place within the wound or natural orifice. As rim3152 is being rolled, the straps 3140 a, 3140 b are pulled causing theinterleaved arcuate portions 3110, 3120 to correspondingly move toeffectively size the diameter “D” of the wound guard 3100 within theaccess device 3000. Rim 3152 is then secured within access device 3000with the wound guard 3100 properly sized therein.

Turning to FIG. 12, smoke evacuation system 700 is provided inaccordance with the present disclosure and is shown generally includingtissue guard 110, tubing 710, 720, a collection reservoir 730, and asmoke evacuation (or vacuum) source 740. The various tissue guardsdisclosed herein are all designed to work with system 700. Tissue guard110 and tubing 710 are detailed above and are coupled to one another,e.g., via engagement of one end of tubing 710 about exhaust connection776 of tissue guard 710. The other end of tubing 710 extends intocollection reservoir 730 in sealing relation therewith.

Collection reservoir 730 includes a base 732 and a lid 734 sealed aboutbase 732. Lid 734 defines first and second ports 736, 738 configured toreceive ends of tubing 710, 720, respectively, in sealing relationtherewith. These ends of tubing 710, 720 extend into the interior volume733 of base 732 and are spaced-apart from one another as well as thebottom of base 732. Tubing 720 extends from collection reservoir 730 tosmoke evacuation source 740 wherein the other end of tubing 720 iscoupled to smoke evacuation source 740. In this manner, upon activationof smoke evacuation source 740, suction is established through lip 126of tissue guard 110, tubing 710, collection reservoir 730, tubing 720,to smoke evacuation source 740. During use, this suction, in addition toevacuating smoke from tissue guard 110, may also suction liquids,tissue, and/or debris through tubing 710. However, as a result of theends of tubing 710, 720 being spaced-apart from one another withincollection reservoir 730 and spaced-apart from the bottom of base 732 ofcollection reservoir 730, the liquids, tissue, and/or debris aresuctioned into collection reservoir 730 and deposited therein, whileonly the smoke and other gaseous fluids are further suctioned fromcollection reservoir 730 through tubing 720 to smoke evacuation source740. As such, smoke evacuation source 740 is protected by inhibitingsuctioning of liquids, tissue, and/or debris into smoke evacuationsource 740.

From the foregoing and with reference to the various drawings, thoseskilled in the art will appreciate that certain modifications can bemade to the present disclosure without departing from the scope of thesame. While several embodiments of the disclosure have been shown in thedrawings, it is not intended that the disclosure be limited thereto, asit is intended that the disclosure be as broad in scope as the art willallow and that the specification be read likewise. Therefore, the abovedescription should not be construed as limiting, but merely asexemplifications of particular embodiments. Those skilled in the artwill envision other modifications within the scope and spirit of theclaims appended hereto.

What is claimed is:
 1. A method for sizing a wound guard in a surgicalsystem for accessing a surgical cavity, comprising: inserting an accessdevice within a surgical or natural opening; tenting the access deviceto secure the access device within the opening; repeatedly inserting oneof a series wound guards of varying length within the access port untilthe wound guard is properly sized therein; and engaging a smokeevacuator atop the access device to secure the wound guard to the accessdevice within the surgical cavity.
 2. A method for sizing a wound guardin a surgical system for accessing a surgical cavity according to claim1 wherein the length of the series of wound guards range from about 2 cmto about 8 cm.
 3. A method for sizing a wound guard in a surgical systemfor accessing a surgical cavity according to claim 1 the smoke evacuatoroperably engages the wound guard to secure the wound guard to the accessdevice.
 4. A method for sizing a wound guard in a surgical system foraccessing a surgical cavity according to claim 1 further comprising:attaching a connection port operably associated with the smoke evacuatorto a smoke evacuation system; and activating the smoke evacuation systemto remove smoke from the operating cavity during surgery.
 5. A surgicalsystem for accessing an operating cavity, comprising: an access deviceconfigured for insertion within an operating cavity, the access deviceincluding an elongated sleeve having proximal and distal rims disposedon opposing sides thereof, the distal rim configured for insertionwithin an operating cavity and the proximal rim configured to seatagainst tissue outside the operating cavity; and a wound guardconfigured for insertion within the access device, the wound guardincluding a pair of interleaved arcuate portions each having a strapslot defined therein configured to receive a respective strap, eachstrap including a proximal end configured to operably engage theproximal rim of the access device and a distal end configured to engagethe distal rim of the access device, wherein tension on the pair ofstraps during insertion and adjustment of the access device moves thepair of interleaved arcuate portions relative to one another tofacilitate properly sizing the wound guard therein.
 6. A surgical systemfor accessing an operating cavity according to claim 5, wherein the pairof interleaved arcuate portions includes a first arcuate portion havingsolid distal end and a second arcuate portion having a split distal enddefining an elongated slot therein configured to receive the soliddistal end.
 7. A surgical system for accessing an operating cavityaccording to claim 5, wherein adjusting the proximal rim of the accessdevice to secure the access device within the operating cavityautomatically adjusts the arcuate portions to size the wound guardtherein.